KATHMANDU, 25 October 2007 (IRIN) - Health workers are increasinglyconcerned about the risk of a diarrhoea outbreak in the hills andsouthern plains of Nepal if adequate medical supplies, health assistanceand sanitation are not provided.

"Due to a lack of medicines and other necessary supplies like salinewater, especially in remote areas, a large number of people could sufferfrom this disease," said government health officer, Rakesh Thakur. Heexpressed concern that in the past few months, dozens of people havebeen killed due to diarrhoea, following floods and landslides around thecountry.

Many remote villages in districts in the eastern Terai and western hillsare vulnerable, as they lack medicines, doctors and sanitationfacilities, according to local government health officers.

In the eastern Terai district of Saptari, nearly 20 people have beenkilled since July when heav y floods devastated the area, destroyinghouses, farms and displacing many poor families, according to the NepalRed Cross Society (NRCS).

In addition, more than 20 people have died in the hill district ofKalikot, 500km northwest of the capital, Kathmandu, considered one ofthe most flood-prone areas, according to NRCS. More than 500 people fromthis village alone had been affected by the disease.

NRCS officials say there is a need for more humanitarian support forthose at high risk of flood-related diseases, and diarrhoea is the worstthreat, especially for young children and infants.

Since July, the monsoon floods have hit nearly 49 districts. The floodsin the Terai and landslides in the hills affected more than 580,000people, destroying 71,000 houses, displacing 24,368 families and killing168 people.

The problems became much worse with heavy water logging for a longperiod, recurring torrential rainfall thereby cutting communicationlinks, including roads and telephones, all of which made humanitarianassistance delivery difficult.

In the worst affected districts, residents are still vulnerable todiarrhoea and cholera, but they lack access to basic services, saidlocal aid workers. They explained that clean drinking water supply,roads, bridges and livelihood services are still in poor condition.

"The number of patients is growing every day and there is a need formore saline water and medical supplies," said Satya Dev Giri ofSagarmatha Zonal Hospital in Rajbiraj.

"The main problem in remote villages is a lack of even a basic knowledgeof sanitation and clean drinking water," said a local health volunteer,Saraswati Shah. She added that if only the villagers were aware of howto prevent diarrhoea, they would not even require a doctor or medicinesto combat such a relatively easily curable disease.